Last updated: Jul 23, 2008
group-support-smoke
Group counseling can increase your chance of quitting by 30%.
(GETTY IMAGES/123RF/HEALTH)
Human beings are creatures of habit—just ask a smoker who has tried to quit. But were also social animals, and when it comes to quitting smoking, the people around us can make a big difference. Group counseling may not be as effective as some other treatments (such as medication), but for people looking for the human touch, it can be just the thing.


The idea of quitting through group therapy or support groups is to develop a plan for putting cigarettes behind you and to learn skills for coping with cravings—while comparing notes (and horror stories) with other would-be quitters. "Supportive group treatments led by a skilled counselor with others quitting at the same time are influential," says Jodi Prochaska, PhD, MPH, a clinical psychologist and assistant professor at the University of California, San Francisco, who works at the universitys Center for Tobacco Control Research & Education. "Making a commitment to quit and announcing that commitment to others has been shown to be helpful."

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According to a large meta-analysis conducted by the U.S. Public Health Service (a division of the U.S. Department of Health and Human Services), group counseling increases ones chances of successfully quitting by about 30%. In the groups included in the study, 14% of the participants, on average, successfully quit—a higher rate than telephone counseling or self-help, but slightly lower than individual counseling.

People quit in "clusters"
Most support-group programs have a two-pronged approach. They start out as purely educational, with group leaders informing members about the available smoking-cessation treatments (from drugs to nicotine-replacement gums and patches); the neurobiology of addiction; and the everyday situations that drive a smokers habit, whether its stress or drinking a cup of coffee.

The psychological aspects of the habit are especially important to understand because they so often lead to relapses, says Linda Thomas, manager of the Tobacco Consultation Service at the University of Michigan Health System. "A lot of people think theyre weak because they tried to quit and couldnt beat the addiction," she says. "One of the things that makes groups successful is helping people understand that smoking is more than a physical addiction. Its integrated into their life and behavior, its a coping mechanism for stress and depression, its the way they socialize."

The second component of a support group is the group dynamic itself. A recent long-term study in the New England Journal of Medicine examined smoking patterns in a group of 12,000 people and concluded that smokers tend to stop smoking in "clusters"—whether or not they are aware of it. The data, which spanned more than 30 years, suggested that the decision to quit spreads via social networks and person-to-person contact in much the same way that fashions or opinions do. The researchers found that the friend of a smoker who quit was 36% more likely to quit, too, and employees of small businesses were 34% more likely to quit if a coworker did.

A group of strangers in the local community center may not be able to influence your personal habits as powerfully as your best friends, but group counseling can be a way of manufacturing social support—a group of lifelong smokers can be pretty influential, after all.

"If the facilitator has done a good job, you develop group cohesion," says Thomas, who has led groups for a decade and reports quit rates of more than 35%. "And when a group develops cohesion, you see both the soothing and the pressuring that takes place among families and friends. If youre really upset, the groups going to protect you and help take care of you. But if you come in and say something that is b.s., theyre going to call you on it."

Find the group that's right for you
There are a number of different options available, most free of charge. Your local hospital can be a great place to start if you want something local. You can also find group counseling through one of the following programs.

In the 1980s, the American Cancer Society (ACS) developed a group-counseling program known as Freshstart, which is now offered in hospitals, workplaces, and other venues across the country. Led by ACS-trained facilitators—more than half of whom are former smokers themselves—the program usually consists of four 30- to 60-minute meetings. Each session includes a lesson delivered by the group leader (on relaxation techniques to stave off cravings, for example), a group discussion, and an individual exercise.

The group discussion component is "probably the most valuable," says Jeff Cross, product manager for the ACSs Employer Initiative program. "Its about exchange and sharing and building that social support within the group."

Another option is Nicotine Anonymous, a 12-step program modeled after Alcoholics Anonymous. Although there have not been any independent scientific studies of its effectiveness, and the spiritual component of 12-step programs may dissuade some people, the organization now boasts more than 200 locations in the United States.

"Back in the 1960s and 1970s, 12-step programs were looked at with some suspicion by the research community," says Edward Lichtenstein, PhD, a senior scientist at the Oregon Research Institute who has observed and written about Nicotine Anonymous. "That has changed considerably. Now theyre quite respected as a legitimate resource for all kinds of addictions." Mainstream smoking-cessation programs at institutions such as the Mayo Clinic sometimes refer people who are trying to quit to Nicotine Anonymous, he adds.

Online support groups may be the group counseling of the future. One of the largest is QuitNet, an online smoking-cessation program started at Boston University that offers online forums, chat rooms, and "clubs." QuitNet is now run by a for-profit company, however, and some features require a membership fee.

Groups are not for everyone
As with most smoking-cessation treatments, support groups generally work best in tandem with other methods—in this case, with medication or the patch, for instance. Some people, however, simply cant imagine opening up to a group at all.

"Like Weight Watchers and other group programs, they work really well for some people but not for entire populations," says Cross. "Some people just arent comfortable with it. The group setting itself may actually present an awkward or uncomfortable social situation, particularly since its focused on something that people want to change about themselves. But the folks who need that connection and support really do benefit greatly."